The dizziness of vertigo can interfere with a person’s life. Chiropractic care may be beneficial.
What is Vertigo?
It is a condition where a patient feels as if there is motion when there is not. It is a type of dizziness due to a vestibular system dysfunction. It can cause balance problems, as well as nausea and vomiting. Objective vertigo occurs when the patient feels as if objects are moving. Subjective vertigo concerns the patient feeling as if they are in motion. A third type, pseudovertigo, is “an intensive sensation of rotation inside the patient’s head”. While this condition can affect anyone, it increases with age and is more common in women. There are several causes of this type of dizziness. Benign paroxysmal positional vertigo (BPPV), vestibular neuritis, labyrinthitis, vestibular migraine, concussion, and excessive alcohol consumption are some of the causes of this vestibular condition. Repetitive spinning can create a temporary type of dizziness, called physiologic vertigo, since it disrupts the vestibular fluids. This kind of dizziness can be classified as central or peripheral. In central vertigo, the patient suffers an injury to the central nervous system (CNS), probably as a brainstem or cerebellum lesion. This can lead to balance disorder and neurologic deficits (i.e., double vision, slurred speech). Peripheral vertigo is caused by inner ear (vestibular) problems. BPPV is the most common form of this condition. Bacterial infections, flu, and inflammation can cause the transient type of this condition. Motion sickness is a common peripheral vertigo. Peripheral vertigo can be accompanied by tinnitus, hearing loss, vomiting, pain, and imbalance.1
Typical medical treatments for this vestibular condition can include scopolamine, anticonvulsants, antihistamines, beta blockers, corticosteroids, benzodiazepines, antibiotics, or even a surgical shunt or ablation.2 Medicationshave side effects, and they don’t necessarily address the underlying cause of the problem. For BPPV, canalith repositioning may be employed. This procedure uses “several simple and slow maneuvers for positioning the head”. It is the hope that these movements allow the particles of the semicircular canals of the inner ear to move to an area of the ear where they can be resorbed without trouble. The positions are each held for about a half of a minute, until abnormal eye movements and other symptoms cease. Patients need to sleep with the head elevated the night after the procedure to allow the particles to settle. Rarely, for patients who don’t respond to this treatment, surgery would be suggested. A “bone plug” would be used to block the part of the inner ear that is causing the dizziness. After surgery, the semicircular canal would be prevented from responding to head movements or particle movements.3
Head and neck trauma, including whiplash, can trigger vertigo and dizziness. It can be treated by chiropractic care. BPPV, a common vertigo, presents with the patient feeling as if the “room is spinning”. Many of the medications prescribed can leave patients tired and unable to drive. Chiropractors offer a natural alternative to medical treatments. They may use repositioning treatments and prescribe vestibular rehabilitation exercises.4 Brandt-Daroff exercises, for example, have the patient sitting on the edge of the bed and moving from one side, to upright, to the other side over one minute intervals. Tai chi may also be a beneficial form of exercise as it can help with balance. Chiropractors can examine a patient’s lifestyle and make nutritional recommendations, including avoiding alcohol, tobacco, and caffeine. Meditation, breathing exercises, and relaxation techniques can help patients with this condition. Finally, chiropractic manipulation can adjust the joints so that they move properly. This is especially helpful in the upper neck, to treat cervicogenic vertigo.5